Monday, February 20, 2012

Why I don't use the term "Behavioral Health"

It was obvious to me from day one that this was a business strategy. When I worked in a hospital I wore a standard white coat and embroidered under my name was the word PSYCHIATRY. I was after all a board certified psychiatrist and every other doctor in the place had their specialty under their name. One day back in the early 1990s, my boss summoned me into his office and said that were were going to replace PSYCHIATRY with BEHAVIORAL HEALTH. After all we did not want to alienate the non psychiatrists working in the department who work on our teams.

Something about that explanation did not add up. The other specialists also worked on teams and did not change the name of their specialty to match the function of the team. Besides the term MENTAL HEALTH was a perfectly respectable term that all of us had worked under for decades. What was the push for BEHAVIORAL HEALTH?

Now we all know that it was part of a business strategy to marginalize professionals and make it seem like a business strategy was somehow good for mental health and psychiatric treatment.

I told my boss that if I was board-certified in behavioral health it might make sense, but barring that I would stick to PSYCHIATRY. He agreed but over the years that followed the term BEHAVIORAL HEALTH has penetrated the marketplace even in the public sector. More importantly the associated management strategies have led to rationed care and access to care as well as lower quality of care for all person with mental health problems.

There has been some movement toward renaming BEHAVIORAL HEALTH UNITS to MENTAL HEALTH UNITS. But I haven't seen that in the Twin Cities or Midwest yet.